In recent years, therapies such as Percutaneous Electrical Nerve Stimulation (PENS) has been proposed and investigated for the management of acute and chronic pain syndromes, PENS is an analgesic therapy that combines advantages of both electro-acupuncture and TENS. PENS therapy utilizes acupuncture-like electrodes placed in the soft tissues to stimulate peripheral sensory nerves at the dermatomal level corresponding to a local pathology.
For many years, particular importance has been attached to stimulation of the vagus nerve. As the tenth cranial nerve, it is the main nerve of the parasympathetic system. It is also involved in the motor control of the larynx and pharynx and transmits taste sensations from the base of the tongue and sensations of touch from the pharynx, larynx and part of the external auditory canal (auricular branch).
Invasive stimulation of the vagus nerve in particular has in the meantime become an established therapeutic procedure in neurology for treatment of epilepsy: Prevention of intractable partial seizures has also been seen in certain instances due as a result of intermittent vagal stimulation in humans:
In the above, the patient's vagus nerve is exposed on the left region of the neck by neurosurgery and a current conductor is wound around it as an electrode. The device for generating current impulses is implanted under the skin in the left shoulder area. The vagus nerve stimulator can later be programmed from outside by means of an electromagnetic field. Electrical excitation of the vagus nerve causes a stimulation of the brain in various areas, as can be demonstrated by imaging methods.
Additional devices that have been employed in vagus nerve stimulation therapies include US Application No. 2012/022633 and U.S. Pat. No. 5,324,287 both to Szeles relate to devices that provide punctual stimulation of nerve endings located in the region of the ears, running to the brainstem nuclei. While such devices have been effective in treatment of certain medical conditions, usage is not without problems and drawbacks. The device disclosed in Szeles cannot be employed for extended periods. Additionally the device disclosed in Szeles lacks the flexibility to tailor treatment modalities to the specific needs and requirements of the patient and/or symptoms under treatment.
Thus it is desirable to provide a minimally invasive devise that can be robust and provide for enhanced performance over a variety of applications.